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C Y Chang

Publications and source records attributed to C Y Chang.

At least 73 records · Page 4Linked to original sources

Sensitivity of diffusion-weighted magnetic resonance imaging in the diagnosis of acute lacunar infarcts.

BACKGROUND AND PURPOSE: Heightened interest in the early diagnosis and treatment of acute stroke challenges neuroimaging specialists to optimize available modalities and to develop new techniques for the evaluation of cerebrovascular disease. The purpose of this study was to evaluate the sensitivity of diffusion-weighted (DW) magnetic resonance (MR) imaging in detecting early small infarcts and in differentiating acute from nonacute small infarcts when conventional MR imaging demonstrates multiple small infarcts. METHODS: Thirty-eight consecutive patients with a clinical diagnosis of lacunar infarcts (20 men and 18 women, aged 50-79 yr) who underwent DW MR imaging within 3 days of symptom onset were enrolled in this study. All patients underwent both conventional fast spin-echo (FSE) MR imaging and DW MR imaging. Apparent diffusion coefficient (ADC) maps were also acquired. All patients had at least one of the following classic lacunar syndromes: pure motor hemiparesis, ataxic hemiparesis, dysarthria-clumsy hand, pure sensory stroke, and sensorimotor stroke. RESULTS: Thirty-six patients (40 acute lesions) had focal areas of high intensity on DW MR imaging associated with their clinical symptoms. Acute lacunar infarcts were seen on DW MR imaging as bright areas of decreased ADC ratio (range 0.31-0.85, mean 0.64). Lesion conspicuity with DW MR imaging was superior to that with FSE in 33 acute lesions. In four patients with small hyperacute (within 6 hours) infarcts, DW MR imaging was particularly sensitive for infarcts that were not visible on FSE sequences. The sensitivity of DW MR imaging and ADC map for acute lacunar infarcts was 95%, specificity 94%, positive predictive value 97%, negative predictive value 90%, and accuracy 95%. In 15 patients with both acute and nonacute old small infarcts, DW MR imaging and ADC map could easily distinguish the new infarct from adjacent old ones, although this distinction was difficult to make with FSE. CONCLUSIONS: DW MR imaging accompanied by ADC map is a sensitive diagnostic modality for hyperacute and acute lacunar infarcts. It is also sensitive in distinguishing fresh small infarcts from adjacent multiple old infarcts.

Acute Disease↗

Image evaluation of suprazygomatic masticator space lesions.

In order to understand lesions involving the suprazygomatic masticator space (SZMS) demonstrated on computered tomography (CT) or magnetic resonance (MR) images, we collected 45 cases of lesions in SZMS. There were hematomas in 26 cases, tumors in 16 cases, and abscesses in 3 cases. The location of these lesions in compartments of the SZMS and adjacent structures was analyzed. Most commonly hematoma was found in the deep loose connective tissue (80.8%), followed by the superficial dense connective tissue (61.5%). Only 2 SZMS hematoma involved the superficial fat pad. Five patients had air accumulation in the SZMS, and all were in the deep fat pad and with maxillary sinus fracture. Of the sixteen cases which were tumors, 12 were extended from adjacent structures, and four were primary tumor. In cases of tumor, compartments of SZMS involved most frequently were temporal muscles (15 of 16 cases), followed by deep fat pad (8 of 16 cases). The connective tissue layer of SZMS is a communication pathway for superficial spread of infection, hematoma, or tumor invasion to or from the scalp and face. Compartments of deep fat pad and temporal muscle are also pathways for the spread of disease to or from the face, intracranium and orbit. The primary tumors in infratemporal fossa and SZMS are rare. Malignant tumors in SZMS usually come from surrounding spaces.

Adolescent↗

Sequential MR studies of a patient with white matter disease presenting psychotic symptoms: ADEM versus single-episode MS.

Acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) are both demyelinating white matter disorders. It is difficult to differentiate ADEM from single episode MS because of the similar clinical presentation, cerebral spinal fluid (CSF) analysis, histological finding and magnetic resonance image (MRI) appearance. We report an ADEM case with unusual clinical presentations of predominant psychiatric symptoms, and relatively long disease course. Initially, we were not able to distinguish it from single episode MS. By means of sequential MR images followed up 2 years and spectroscopy studies, and the dramatic clinical improvement after corticosteroid therapy, ADEM was diagnosed as the disease entity of this patient. In this case report we will present the MR findings of this patient and discuss the differentiation between the ADEM and MS.

Adult↗

Magnetic resonance imaging appearance of intradural spinal lipoma.

Intradural spinal lipoma not associated with spinal dysraphism is a rare tumor often presenting with nonspecific symptoms and indolent clinical course. Its intradural location and fat component is the key for proper preoperative diagnosis, which could hardly be made by traditional imaging studies including plain film and myelography. Both CT and MRI can reveal the fat component of the tumor, but MRI is superior to CT in demonstrating its relationship with adjacent normal nerve tissue. We report a 32-year-old man who had back pain for years and the symptom progressed rapidly in recent two months. MRI revealed an intradural tumor at T12 level with high signal intensity on both T1- and T2-weighted images. The signal intensity dropped dramatically with fat saturation technique, which confirmed fat as its main component. The patient received surgery and the tumor was proved to be an intraspinal lipoma.

Adult↗

Lithopedion.

Lithopedion is a rare obstetrical outcome of an undiagnosed and untreated advanced abdominal pregnancy, mostly found incidentally. We present a case of lithopedion. In a 76 year-old female suffering from cervical neoplasm, total abdominal hysterectomy was performed for the lesion and the lithopedion was found incidentally. The patient's history was unremarkable, and laboratory tests were normal. The patient recalled having experienced a severe abdominal pain about 50 years before. Her physician had felt "a benign tumor" in her pelvis at that time, indicating that the stone child had retained in the maternal peritoneal cavity for 50 years.

Female↗

Liquid products from oxidative thermal treatment of oil sludge with different oxygen concentrations of air.

Oxidative thermal treatment of oil sludge with different oxygen concentrations of air by using a dynamic thermogravimetric (TG) reaction system is investigated. The experimental conditions employed are: gas flow rate of 50 cm3/min (value at 298 K) for 300 mg dry waste, a constant heating rate of 5.2 K/min, the oxygen concentrations in air of 1.09, 8.62 and 20.95 vol. % O2, and the temperature (T) range of 378-873 K. From the experimental results, the residual mass fractions (M) are about 78.95, 28.49, 8.77 and 4.13 wt. % at the oxidative T of 563, 713, 763 and 873 K for the case with 20.95 vol. % O2, respectively. The values of M with 8.62 and 1.09 vol. % O2 at T of 873 K are 4.87 and 9.44 wt. %, respectively. The distillation characteristics of the oil portion of liquid products (condensates of gas at 298 K) from the oxidative thermal treatment of oil sludge with 20.95 vol. % O2 at T of 378-873 K is close to those of commercial gasoline. Nevertheless, the liquid product contains a large amount of water. The distillation characteristics of the oil portions of liquid products with 8.62 and 1.09 vol. % O2 at T of 378-873 K are close to those of diesel and fuel oils, respectively. The oil quality with 8.62 vol. % O2 is better than that with 1.09 vol. % O2. However, the liquid product with 8.62 vol. % O2 still contains a large amount of water; nonetheless, that with 1.09 vol. % O2 is with negligible water. Compared with the oil product of nitrogen pyrolysis, the oil quality with 1.09 vol. % O2 is better. Certainly, low oxygen conditions (i.e. 1.09 vol. % O2) not only accelerate the thermal reaction of oil sludge, but also at the same time avoid or reduce the production of water. Further, from the analysis of benzene (B), ethylbenzene (E), toluene (T) and iso-xylene (X) concentrations of the oil portion of liquid products, the BETX concentrations of oil with 20.95 vol. % O2 are higher than those with 8.62 and 1.09 vol. % O2. The yields of liquid products with 20.95, 8.62 and 1.09 vol. % O2 at T of 378-873 K are 31.96, 34.42 and 37.3 wt. %, respectively. From the experimental results, the improvement effects of oxygen on the qualities of the oil portion of liquid products are obvious. The above technique not only formats good quality gasoline and diesel oils but also reduces large amount of oil sludge. If the oil exists with water, it may be obtained by further separation or collected by fractional condensation.

Air↗

Sequential MRI studies of a patient with complex partial status--a case report.

Complex partial status (CPS), the status epilepticus of complex partial seizure, is rarely seen in clinical practice. The clinical presentations of CPS are characterized by confusion, slowness in response, together with stereotypic or complex automatisms and occasional secondary generalization. The electroencephalographic findings of CPS reveal characteristic focal epileptiform activities of mesial temporal region. Magnetic resonance image (MRI) is the imaging method of choice for studying epilepsy, particularly when focus is in the temporal lobe. We report a 49-year-old female with diagnosis of viral encephalitis and clinical presentation of CPS. We present the sequential brain MRI findings at acute, subacute and chronic stages of this patient.

Brain↗

Molecular basis of the Kell-null phenotype: a mutation at the splice site of human KEL gene abolishes the expression of Kell blood group antigens.

The Kell blood group system is polymorphic, and 23 antigens have been defined to date. The Kell antigens are located on a single red cell transmembrane glycoprotein, encoded by the 19 exons of the KEL gene. The different Kell phenotypes result from point mutations leading to amino acid changes in the Kell glycoprotein. An unusual phenotype, which is defined as the complete lack of all of the Kell antigens, has been identified and designated as the Kell-null or Ko phenotype. The coding region of the KEL gene of the Ko individual showed a normal KEL2/KEL4/KEL7 gene sequence; nevertheless, a G to C mutation at the splice donor site (5' splice site) of intron 3 was found to be present as a homozygote in the individual. The mutation destroys the conserved GT sequence of the splice donor site. Reverse transcription-polymerase chain reaction analysis showed the absence of the complete KEL mRNA. Instead, a major transcript with the exon 3 region skipped was found. The exon 3 of the KEL gene encodes the transmembrane domain of the Kell glycoprotein, and a transcript without exon 3 is predicted to have a premature stop codon that abolishes the translation of C-terminal segment. The segment contains all of the known positions responsible for characterizing different Kell antigens, and this explains the lack of all Kell antigens in Ko red cells.

Alleles↗

The formation of disinfection by-products in water treated with chlorine dioxide.

In this study, chlorine dioxide (ClO(2)) was used as an alternative disinfection agent with humic acid as the organic precursor in a natural aquatic environment. The major topics in this investigation consisted of the disinfection efficiency of ClO(2), the formation of disinfection by-products (DBPs), and the operating conditions. The results indicated that the pH value (pH 5-9) did not affect the efficiency of disinfection while the concentration of organic precursors did. The primary DBPs formed were trihalomethanes (THMs) and haloacetic acids (HAAs). The distribution of the individual species was a function of the bromide content. The higher the ClO(2) dosage, the lower the amount of DBPs produced. The amount of DBPs increased with reaction time, with chlorite ions as the primary inorganic by-product.

Chlorine Compounds↗

Development of peptide antagonists that target estrogen receptor-cofactor interactions.

We have developed a series of high-affinity peptide antagonists that inhibit the transcriptional activity of both subtypes of the human estrogen receptor (ERalpha and ERbeta). We believe that it will be possible to develop these peptides, or corresponding peptidomimetic derivatives, into pharmaceuticals for use in the treatment of breast cancer and other estrogenopathies. It is anticipated that drugs of this type could be used in combination with classical antiestrogens, such as tamoxifen, to achieve a complete blockage of ER-transcriptional activity. Although ER has been the primary target of our studies to date, it is likely that the insights gained from this work will apply to other nuclear receptors and transcription factors.

Amino Acid Motifs↗

Human histo-blood group ABO glycosyltransferase genes: different enhancer structures with different transcriptional activities.

The enhancer element of the human histo-blood group ABO glycosyltransferase gene has been demonstrated to be located -3.7 kb upstream from the transcription start site and to be composed of four tandem repeats of a 43-bp unit. Recently we identified three different enhancer structures among the allelic A, B, and O glycosyltransferase genes. The enhancer structure with four 43-bp units is present in the B and O genes, but not in the A gene. The corresponding enhancer region of the A gene contains only one 43-bp unit, and within this unit a nucleotide substitution exists when compared with the consensus sequence. Through transient transfection assays, the transcriptional activity of the A-gene enhancer region was demonstrated to be less than 1% of that of the B-gene enhancer. The difference between the transcriptional activities of the two enhancers became more significant when acting in concert with the ABO-gene's native promoter. The different repeat numbers of the 43-bp unit possessed by the two allelic genes were shown to be the main reason for the vast difference in the transcriptional activities between the A-gene and B-gene enhancers.

ABO Blood-Group System↗

ATM gene deletion in patients with adult acute lymphoblastic leukemia.

BACKGROUND: Loss of heterozygosity (LOH) at the ATM gene (mutated in ataxia telangiectasia [AT] patients) and ATM protein deficiency occur in 14% and 34%, respectively, of patients with chronic lymphocytic leukemia (CLL). ATM protein deficiency also is associated with aggressive disease and worse patient survival. Considering the aberrations in the ATM gene in CLL and the high rate of incidence of lymphoid neoplasias in AT patients, the authors investigated its incidence rate and significance in patients with adult acute lymphoblastic leukemia (ALL). METHODS: Samples from 36 adults with ALL were analyzed for LOH and homozygous deletion (HD) using a panel of three microsatellite markers located at the ATM gene (D11S2179), the MLL gene (D11S1356), and the BCL1 gene (D11S987) loci. These markers are located within the 11q13-q23 locus. RESULTS: Of the 36 informative cases, 10 (28%) showed deletions (7 LOH and 3 HDs) at the D11S2179 marker. In two patients, the deletions were extended to the MLL gene locus. These deletions were submicroscopic because only 3% (1 of 36) of patients showed abnormalities involving 11q23 using cytogenetic studies. The authors also estimated the levels of ATM protein in 15 ALL patients and 12 healthy volunteers by radioimmunoassay. The ATM protein levels in cases with LOH at the ATM gene were between 15-50% of those from normal bone marrow. In contrast to CLL patients, patients with LOH or HD at the ATM gene locus showed better survival compared with patients without ATM gene deletions (P = 0.003). CONCLUSIONS: LOH of the ATM gene and protein deficiency are common in adult ALL, are not demonstrated at the cytogenetic level, and are associated with a favorable prognosis. The authors speculate that ATM deficiency may increase the sensitivity of leukemic blasts to the chemotherapy used during induction and after disease remission in patients with adult ALL. The relatively high frequency of deletion of the D11S2179 marker compared with the D11S1356 marker suggests that ATM is the target gene of the deletion at the 11q23 locus, and that such deletions may play a role in the pathogenesis of ALL.

Adult↗

Total plasma malondialdehyde levels in 16 Taiwanese college students determined by various thiobarbituric acid tests and an improved high-performance liquid chromatography-based method.

OBJECTIVES: In determining the plasma malondialdehyde MDA levels in some Taiwanese college students, we found rather different results by using different thiobarbituric acid TBA tests, even by the high-performance liquid chromatography HPLC-based methods. Here, we re-evaluated four commonly used TBA tests and improved the HPLC-based test. DESIGN AND METHODS: We used the blood plasma of 16 college volunteers to determine plasma MDA by using four methods: a spectrophotometric measurement of thiobarbituric acid-reactive substances (TBARS) in the TCA-supernatant of plasma (Method A); a fluorescence measurement of plasma lipid peroxides (Method B); and two different HPLC-based measurements of MDA with either 532-nm measurement (Method C, HPLC/532 nm) or fluorescence measurement (Method D, HPLC/fluor.). RESULTS: The levels of MDA or TBA reactive substances obtained from the four methods differed substantially (0.39 +/- 0.15; 2.14 +/- 0.73; 0.75 +/- 0.22; and 0.38 +/- 0.15 microM for Methods A, B, C, and D, respectively). The results were positively correlated between Methods A and B (r = 0.740, p < 0.02) and between Methods C and D (r = 0.516, p < 0.05). However, results were negatively correlated between Methods B and D (r = -0.548, p < 0.05). Because most plasma MDA is bound to proteins, we modified the HPLC-based methods (C and D) by adding an alkaline hydrolysis step, and the plasma TBA-MDA adduct detected by HPLC/532 nm was referred to as total MDA. RESULTS show that alkaline hydrolysis was a critical step for measurement of total MDA in plasma because this treatment led to release of MDA from plasma proteins. We also adapted the potassium iodide (KI) treatment of plasma from Method D to reduce lipid hydroperoxides. Our modified method gave a total MDA level in the 16 volunteers of approximately 1.5 microM, which was equal to protein-bound MDA plus free MDA. This total MDA level was positively (p < 0.05) correlated with the level of TBA reactive substances obtained from Methods C (r = 0.63, p < 0.05) and D (r = 0.48, p < 0.07), but was not correlated with those from Methods A and B. The recovery (84 approximately 105%), precision (within-assay coefficient of variation: 2.4%, between-assay coefficient of variation: 4 approximately 8%) and sensitivity of the modified procedure were comparable to other HPLC-based methods. CONCLUSION: By using a validated modification of HPLC-based TBA method, the total plasma MDA in 16 Taiwanese college students was found to be 1.54 microM, which was relatively high compared to those obtained by other HPLC-based method, primarily due to the release of protein-bound MDA by alkaline hydrolysis. This level equaled the sum of protein-bound MDA and free MDA in plasma, confirming that this level represents total plasma MDA.

Adult↗

The formation and control of disinfection by-products using chlorine dioxide.

In this study, chlorine dioxide (ClO2) was used as an alternative disinfectant with vanillic acid, p-hydroxybenzoic acid, and humic acid as the organic precursors in a natural aquatic environment. The primary disinfection by-products (DBPs) formed were trihalomethanes (THMs) and haloacetic acids (HAAs). Under neutral conditions (pH = 7) for vanillic acid, more total haloacetic acids (THAAs) than total trihalomethanes (TTHMs) were found, with a substantial increase during the later stages of the reaction. In the case of p-hydroxybenzoic acid, the amount of THAAs produced was minimal. Raising the concentration of ClO2 was not favorable for the control of THAAs in low concentrations of vanillic acid. ClO2 could reduce the total amount of TTHMs and THAAs for higher concentration of vanillic acid. It was found that the humic acid treatment dosage was not significant. Under alkaline conditions (pH = 9), the control of TTHMs and THAAs for the treatment of vanillic acid was better and more economical, however, an appreciable amount of inorganic by-products were observed. Under the same alkaline condition, the control of THAA for the treatment of p-hydroxybenzoic acid was not beneficial and for the treatment of humic acid was not significant.

Chlorine Compounds↗

The pH and anion effects on the heterogeneous photocatalytic degradation of o-methylbenzoic acid in TiO2 aqueous suspension.

This investigation used UV light of 365 nm and titanium dioxide in aqueous suspension to study the photocatalytic reaction of o-methylbenzoic acid under the influence of pH values, anion additives and the varieties of titanium dioxide. From experimental results, under the condition of 5 g/l TiO2, pH 3 and light intensity of 2.45 mW/cm2, 0.1 mM of o-methylbenzoic acid could be completely decomposed in 2 h. The reaction was faster with lowering pH, and was found to be apparent first-order following Langmuir-Hinshelwood model. In the presence of anion additives, the inhibitive effect of chloride ions was larger than that of sulfate ions under acidic condition for Degussa brand titanium dioxide, but without influence using Janssen brand. Both brands, however, promoted the mineralization of o-methylbenzoic acid (o-MBA).

Anions↗

Effect of verapamil on cholesteatoma migration in vitro.

OBJECTIVES: It was previously shown that cholesteatoma migration in vitro is influenced by the calcium concentration of the culture medium. This study was designed to determine whether the calcium channel blocker verapamil affects cholesteatoma migration in vitro. METHODS: Cholesteatoma cells harvested from patients with chronic ear disease were grown in culture and were exposed to culture medium containing verapamil. The migration rate of the verapamil-exposed cells was compared with control rates. RESULTS: Verapamil at 300 microgram/L caused marked reduction in the rate of migration compared with control values. The migration rate returned to normal within 48 hours after verapamil was removed from the culture medium. Higher verapamil concentrations (500 microgram/L) caused complete detachment of the epithelial cells from the substrate within 24 hours. CONCLUSION: Our findings suggest that cholesteatoma migration in vitro is calcium channel dependent and can be reduced with calcium channel blockers such as verapamil.

Calcium↗